Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $34.67 / $37.15	Facility	26	$33.11	$34.67	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $173.78	Professional		$66.07	$89.13	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $50.12 / $107.15	Professional	26	$37.15	$50.12	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $40.74 / $77.62	Professional	TC	$19.50	$40.74	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $144.54	Professional		$70.79	$89.13	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $64.57	Professional	26	$38.02	$52.48	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $45.71 / $66.07	Facility	26	$10.00	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $213.80	Professional		$69.18	$102.33	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $58.88 / $120.23	Professional	26	$38.02	$58.88	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.65 / $89.13	Professional	TC	$27.54	$43.65	$89.13
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $87.10	Professional		$30.90	$61.66	$87.10
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.20 / $46.77	Professional	26	$20.42	$30.20	$46.77
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $28.18 / $44.67	Professional	TC	$10.23	$28.18	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $117.49	Professional		$32.36	$51.29	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $141.25	Professional		$53.70	$75.86	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $83.18	Professional	26	$33.11	$46.77	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.20 / $56.23	Professional	TC	$18.62	$30.20	$56.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $81.28	Professional		$40.74	$63.10	$81.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	26	$30.90	$30.90	$30.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $32.36 / $32.36	Professional	TC	$32.36	$32.36	$32.36